2.2.4. School intervention components

We partnered with Richmond Public School nursing leadership to determine the best way to adapt the school nurse intervention components for the virtual setting. Given that school nurses would be in contact with students via telephone or in a virtual clinic during the school year, they were given a modified data form to record their interactions with participants. Prior to COVID-19, when children were in school and seen at the clinic for asthma, school nurses recorded on a data form what steps they took (following a standardized action plan) in response to the child's asthma symptoms. Given that nurses were not managing child asthma symptoms in school, we adapted the clinic data form for the remote setting to capture information about: 1) how the child's asthma was at home, 2) if the family had any concerns about the child's asthma, 3) whether the family had an asthma action plan at home, 4) whether the family had the appropriate medications at home, and 5) if the school nurse felt the child needed to follow up with their asthma provider. This form was then sent to the project coordinator, and the research team and family's CHW followed up with the family as appropriate. We also found that, although the school nurses appreciated having RVA Breathes to help support families, they were overwhelmed with other priorities in the virtual school setting. Thus, by adapting our school intervention to require no additional meetings between school nurses and participants, it was feasible for school nurses to continue their participation during the pandemic. We also continued to provide asthma education to school nurses remotely throughout the school year as requested, either through handouts or virtual meetings.